The Imaginary Invalid
62-year old Alicon ( not her real name), referred by her physician, walked into my office complaining of chronic aches and pains. I took her medical history and discovered that there wasn’t anything physically wrong with her.
Alicon’s unexplained physical complaints began before she was 30, which resulted in her seeking treatment from various doctors, finally impairing her ability to work but also her sexual relationship with her husband.
Alicon’s symptoms were pain in the joints, extremeties, head, abdomen, back and pain during intercourse. She also displayed various gastrointestinal symptoms, difficulty in swallowing, lump in throat, double vision and sexual indifference.
Alicon was suffering from Somatisation Disorder. SD is a somatoform disorder, which means that the physical symptoms have a psychological origin.
True to her diagnosis, Alicon was a poor historian of her life, giving dramatic and exaggerated descriptions of her physical symptoms and playing down or denying any psychosocial links with her symptoms. She was convinced she had some organic illness. She tended to be irritable to those around her, and she had difficulty expressing emotion.
After months in therapy, Alicon is now beginning to open up to the idea that her somatic complaints are psychosomatic, and that they have been her way of avoiding psychological pain.
The more Alicon is willing to look into her family history, the more she is able to come to terms with the inalterability of the past. It was not so much a question of forgiving the verbal and emotional abuse that she had endured growing up, I said to her, but that sooner or later she would have to give up the hope for a better past. This led her to make some peace with her family history.
This new-found peace seems to have contributed to her experiencing lower levels of anxiety and less somatic complaints, allowing her to focus on developing more intimacy in her marriage.